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Paediatric diabetes

Danièle Pacaud, Jean-François Lemay, Erick Richmond, Stéphane Besançon, Dhruvi Hasnani, Sujata M Jali, Carmen Mazza
Diabetes affects many children living in developing countries. Through an informal survey, five SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) centers from developing countries (Mali, Costa Rica, Argentina and two from India) share their perspective on caring for children with diabetes. Each center provides a description of the population of children with diabetes they serve, the organization of care, and the challenges encountered on a daily basis in the provision of this care...
October 2016: Pediatric Diabetes
Berglind Jonsdottir, Christer Larsson, Annelie Carlsson, Gun Forsander, Sten Anders Ivarsson, Åke Lernmark, Johnny Ludvigsson, Claude Marcus, Ulf Samuelsson, Eva Örtqvist, Helena Elding Larsson
CONTEXT: Screening of autoimmune thyroid disease in children and young adults with Type 1 diabetes is important but vary greatly between clinics. OBJECTIVE: The aim was to determine the predictive value of thyroid autoantibodies, thyroid function, islet autoantibodies, and HLA- DQ at diagnosis of Type 1 diabetes for autoimmune thyroid disease during subsequent follow-up. SETTING: 43 Paediatric Endocrinology units Sweden. Design, patients and main outcome measures: At diagnosis of Type 1 diabetes, samples from 2433 children were analysed for autoantibodies against thyroid peroxidase (TPOAb), thyroglobulin (TGAb), glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated protein-2 (IA-2A), and the three variants of the zinc transporter 8 (ZnT8W/R/QA) as well as HLA-DQA1-B1 genotypes and thyroid function...
October 14, 2016: Journal of Clinical Endocrinology and Metabolism
Bedowra Zabeen, Jebun Nahar, Samin Tayyeb, Fauzia Mohsin, Nazmun Nahar, Kishwar Azad
INTRODUCTION: Recent data show that the prevalence of diabetes among children and adolescents is increasing in some ethnic groups. The worldwide epidemic of childhood obesity has been accompanied by an increase in the incidence of type 2 diabetes (T2D) in youth. METHODS: The aim of this study was to describe the baseline characteristics of children and adolescents diagnosed ≤18 years who had features of T2D and presented at Changing Diabetes in Children, Paediatric Diabetes Clinic at Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine, and Metabolic Disorders...
September 2016: Indian Journal of Endocrinology and Metabolism
M Incani, C Serafini, C Satta, L Perra, F Scano, P Frongia, R Ricciardi, C Ripoli, M Soro, A Strazzera, S Zampetti, R Buzzetti, M G Cavallo, E Cossu, M G Baroni
BACKGROUND: The incidence of T1DM In Sardinia is among the highest in the world (44.8 cases/100,000 person-years). Recommendations of the Immunology of Diabetes Society (IDS) advise evaluating autoantibody positivity in first-degree relatives (FDR) of patients with T1DM, for their higher risk to develop the disease. The aim of this study is to determine the prevalence of beta-cell autoimmunity in first-degree relatives of T1DM patients in Sardinia. METHODS: 188 Sardinian families were recruited in collaboration between Diabetes and Paediatric Units of University and District Hospitals in Sardinia...
October 11, 2016: Diabetes/metabolism Research and Reviews
Eleanor R Gunn, Benjamin B Albert, Paul L Hofman, Wayne S Cutfield, Alistair J Gunn, Craig A Jefferies
BACKGROUND: There has been little change in the incidence of diabetic ketoacidosis (DKA) in newly diagnosed type 1 diabetes mellitus (T1DM) in children and adolescents in most developed countries. OBJECTIVES: To assess potentially modifiable antecedents of DKA in children <15 years of age with new onset T1DM. METHODS: Retrospective review of prospectively collected data from a complete regional cohort of children with T1DM in Auckland (New Zealand) from 2010 to 2014...
October 11, 2016: Pediatric Diabetes
Kung-Ting Kao, Matthew A Sabin
BACKGROUND: The incidence of type 2 diabetes mellitus (T2DM) in children and adolescents is increasing, mirroring the epidemic of paediatric obesity. Early-onset T2DM is associated with poor long-term outcomes. OBJECTIVE: In this article, we describe the growing problem of early-onset T2DM in Australia, explore the difference between early-onset and adult-onset T2DM, and review the management of T2DM in children and adolescents. DISCUSSION: T2DM is difficult to differentiate from the more common type 1 diabetes mellitus (T1DM) in the paediatric population...
June 2016: Australian Family Physician
Jenny Peplies, Claudia Börnhorst, Kathrin Günther, Arno Fraterman, Paola Russo, Toomas Veidebaum, Michael Tornaritis, Stefaan De Henauw, Staffan Marild, Dénes Molnar, Luis A Moreno, Wolfgang Ahrens
BACKGROUND: This study investigates prospective associations of anthropometrical and lifestyle indices with insulin resistance (IR) in European children from the IDEFICS cohort. Insulin resistance (IR) is a growing concern in childhood obesity and a central aspect of the metabolic syndrome (MS). It most likely represents the link between obesity and type 2 diabetes. METHODS: This longitudinal study included 3348 preadolescent children aged 3 to 10.9 years from 8 European countries who were observed from 2007/2008 to 2009/2010...
2016: International Journal of Behavioral Nutrition and Physical Activity
P Ross, A R Gray, J Milburn, I M Kumarasamy, F Wu, S Farrand, J Armishaw, E Wiltshire, J Rayns, P Tomlinson, B J Wheeler
AIMS: While there have been many outcome-focussed studies examining insulin pump therapy, only a few have looked at potential adverse events (AEs), with none examining the relationship between AEs and pump/infusion set type, ethnicity or socio-economic status. In addition, current data on the incidence and characteristics of pump-associated AEs are confined to one paediatric centre. We aimed to describe the incidence, characteristics and potential predictors of insulin pump-associated AEs in New Zealand adults and children with T1DM...
September 1, 2016: Acta Diabetologica
John Porter, Joanne Blair, Richard J Ross
Cortisol has a distinct circadian rhythm with low concentrations at night, rising in the early hours of the morning, peaking on waking and declining over the day to low concentrations in the evening. Loss of this circadian rhythm, as seen in jetlag and shift work, is associated with fatigue in the short term and diabetes and obesity in the medium to long term. Patients with adrenal insufficiency on current glucocorticoid replacement with hydrocortisone have unphysiological cortisol concentrations being low on waking and high after each dose of hydrocortisone...
August 31, 2016: Archives of Disease in Childhood
Jane N T Sattoe, Mariëlle A C Peeters, Sander R Hilberink, Erwin Ista, AnneLoes van Staa
INTRODUCTION: To support young people in their transition to adulthood and transfer to adult care, a number of interventions have been developed. One particularly important intervention is the transition clinic (TC), where paediatric and adult providers collaborate. TCs are often advocated as best practices in transition care for young people with chronic conditions, but little is known about TC models and effects. The proposed study aims to gain insight into the added value of a TC compared with usual care (without a TC)...
2016: BMJ Open
Antonella Mosca, Claudia Della Corte, Maria Rita Sartorelli, Francesca Ferretti, Francesco Nicita, Andrea Vania, Valerio Nobili
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adolescents, due to the increased worldwide incidence of obesity among children. It is now clear enough that of diet high in carbohydrates and simple sugars are associated with hepatic steatosis and non-alcoholic steatohepatitis (NASH). Several studies have shown that an increased consumption of simple sugars is also positively associated with overweight and obesity, and related co-morbidities, such as type 2 diabetes, metabolic syndrome and NAFLD...
August 26, 2016: Eating and Weight Disorders: EWD
Magda Kaczor, Michał Skalski
Insomnia presents an increasing and significant health issue in paediatric population. As the problem had grown over past decade, it became recognised by the specialists dealing with children and adolescents. In a recent study American Academy of Child and Adolescent Psychiatry members were asked about their experience with patients complaining about sleep disturbances. Doctors reported that sleep was a problem for 1/3 of their patients out of which 1/4 required pharmacotherapy [1]. Multiple studies concerning adults confirmed significance of healthy sleep in optimal cognitive, emotional, social and biological functioning...
2016: Psychiatria Polska
Veronica Mericq, Alejandro Martinez-Aguayo, Ricardo Uauy, German Iñiguez, Manouk Van der Steen, Anita Hokken-Koelega
Accumulating evidence suggests that both the intrauterine environment and growth during early life can influence the development of chronic noncommunicable diseases, such as type 2 diabetes mellitus and cardiovascular disease, in adulthood. Here, we review the available human data supporting increased metabolic risk among children born premature or small for gestational age; the adrenal and pubertal modifications that contribute to this risk; metabolic changes that occur during adolescence and early adulthood; and approaches to potentially modify or decrease risk of metabolic disease...
August 19, 2016: Nature Reviews. Endocrinology
Russell M Viner, Billy White, Rakesh Amin, Catherine Peters, Amal Khanolkar, Deborah Christie, Peter C Hindmarsh
BACKGROUND: There is marked variation in diabetes outcomes for children and adolescents across the UK. We used modelling techniques to examine the independent contributions of deprivation, ethnicity, insulin pump use, and health service use on HbA1c trajectories across adolescence. METHODS: Prospective data from a large UK Paediatric & Adolescent Diabetes Service on subjects with type 1 diabetes (T1D) aged 9-17 years from January 2008 to December 2013: 2560 HbA1c datapoints were available on 384 patients [193 (50...
August 18, 2016: Pediatric Diabetes
Doerte Hilgard, Katja Konrad, Michael Meusers, Bela Bartus, Klaus-Peter Otto, Rudolf Lepler, Edith Schober, Esther Bollow, Reinhard W Holl
BACKGROUND: The interaction between type 1 diabetes mellitus (T1DM) and attention deficit hyperactivity disorder (ADHD) in children and adolescents has been studied rarely. We aimed to analyse metabolic control in children and adolescents with both T1DM and ADHD compared to T1DM patients without ADHD. PATIENTS AND METHODS: Auxological and treatment data from 56.722 paediatric patients (<20 years) with T1DM in the multicentre DPV (Diabetes Prospective Follow-up Initiative) registry were analysed...
August 15, 2016: Pediatric Diabetes
A D Lalayiannis, C Thompson, R Malcomson, D V Milford
BACKGROUND: Nodular glomerulosclerosis is seen in insulin dependent diabetic patients with nephropathy. Kimmelstiel-Wilson nodules on biopsy are considered pathognomonic. Diabetic nephropathy is a spectrum of glomerular and tubular disease which correlates with the duration of the diabetes and the extent of glycaemic control. CASE REPORT: An eleven year old girl with cystic fibrosis was referred with persistent heavy proteinuria. She underwent a renal biopsy which revealed nodular glomerulosclerosis with Kimmelstiel-Wilson-like nodules...
2016: Respiratory Medicine Case Reports
Dhaara Iyer, Deepak Choudhary, Juliana Chizo Agwu
INTRODUCTION: Type 1 diabetes (T1D) is characterised by autoimmune destruction of pancreatic β cells leading to insulin deficiency. Prompt referral to a specialist paediatric diabetes team (PDT) for insulin initiation and further management is important to prevent diabetic ketoacidosis (DKA), which remains the most common cause of death in this condition. OBJECTIVE: The aim was to study the timeliness of referrals from general practitioners (GPs) to PDT, of children suspected of having TID...
August 3, 2016: Postgraduate Medical Journal
Yitian Zhao, Yalin Zheng, Yonghuai Liu, Jian Yang, Yifan Zhao, Duanduan Chen, Yongtian Wang
Leakage in retinal angiography currently is a key feature for confirming the activities of lesions in the management of a wide range of retinal diseases, such as diabetic maculopathy and paediatric malarial retinopathy. This paper proposes a new saliency-based method for the detection of leakage in fluorescein angiography. A superpixel approach is firstly employed to divide the image into meaningful patches (or superpixels) at different levels. Two saliency cues, intensity and compactness, are then proposed for the estimation of the saliency map of each individual superpixel at each level...
July 21, 2016: IEEE Transactions on Medical Imaging
Amal R Khanolkar, Rakesh Amin, David Taylor-Robinson, Russell Viner, Justin Warner, Terence Stephenson
PURPOSE: Ethnic minority children are at a greater risk for type 2 diabetes (T2D). However, current prevalence of T2D among children and young people is unknown in England and Wales. In addition, little is known on glycemic control in pediatric T2D globally. METHODS: Using data from the National Paediatric Diabetes Audit for 2012-2013 with >98% coverage of diabetes cases, we estimated (1) the overall, gender- and ethnic-specific prevalence of T2D in children and young people <16 years and (2) whether ethnicity predicts glycemic control (measured by mean HbA1c) in children and young people <19 years...
September 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Irén Tiberg, Björn Lindgren, Annelie Carlsson, Inger Hallström
BACKGROUND: Practices regarding hospitalisation of children at diagnosis of type 1 diabetes vary both within countries and internationally, and high-quality evidence of best practice is scarce. The objective of this study was to close some of the gaps in evidence by comparing two alternative regimens for children diagnosed with type 1 diabetes: hospital-based care and hospital-based home care (HBHC), referring to specialist care in a home-based setting. METHODS: A randomised controlled trial, including 60 children aged 3-15 years, took place at a university hospital in Sweden...
2016: BMC Pediatrics
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